Tennessee, Prescription Drugs, and Heroin

Drug addiction is an increasing problem across the country. Prescription drug addiction has added a new twist to the problem in recent decades. Some blame the problem on doctors overprescribing medications, others claim the prescription system does not have enough controls, and others think pharmaceutical companies are producing stronger painkillers without stringent warnings about the possibility of addiction.

Though drug addiction is a national problem, there are pockets of particular concern. The state of Tennessee, for instance, is facing a near epidemic of drug addiction. In addition to the severe increases in prescription drug addiction in that state, some believe a direct line can be traced from prescription drugs to heroin, which has become widely available. Opioid pain relievers can produce a high similar to heroin, another opium derivative, and heroin is cheaper. Authorities in Tennessee are working to get this problem under control.

Tennessee Prescription Drug Problem

According to news reports, officials in Tennessee refer to the prescription drug problem as an epidemic, and they blame the problem on “doctor shopping,” pill mills, and overprescribing. People seeking opioid pain relievers for recreational use will visit several doctors with the same complaint of pain to obtain multiple prescriptions. Certain medical clinics have developed a reputation as pill mills — places where it is easy to get a prescription for narcotics. Many doctors end up overprescribing opioid pain relievers for legitimate injuries.

An emerging practice area, pain management has an increasingly large niche in the medical profession, partly due to new pharmaceuticals and a better understanding of the pain cycle. Diagnosing pain, however, is completely dependent on the patient. Doctors do not have tests to indicate how much pain a person is experiencing. They must trust what the patient tells them and their instincts about physical conditions and human nature. A patient cannot prove he is in pain and the doctor cannot prove he is not.

Despite the prescription system, which is designed to limit access to dangerous narcotics, opioid pain relievers are easy to obtain. People seeking prescription drugs for recreational purposes quickly figure out where there are holes in the tracking system. By visiting multiple doctors who do not communicate with each other, patients can obtain multiple prescriptions at the same time. Although pharmacies keep track of the prescriptions they fill, most do not coordinate this information with other pharmacies. Therefore, a second prescription can be filled at a different pharmacy across town without any suspicion.

People who are abusing prescription painkillers find other ways to get their pills. Despite the prohibition on sharing prescription medication, it happens all the time. With the right story or for the right price, prescription drugs can be obtained from friends or co-workers. Doctors often write these prescriptions on an as-needed basis, knowing the pain from surgery or injury will likely subside before the prescription runs out. It is more convenient to write it for a 14-day supply or whatever the insurance company will issue at one time, rather than to have the patient return in a few days if more is needed.

No one takes back the unused pills when their injury heals and they no longer have pain. Everyone seems to place some sense of value on pharmaceuticals, whether is it because of the cost or the hassle of getting a prescription filled. When there are leftover pills, many people save them for the next time they have pain and can medicate themselves instead of taking a costly trip to the doctor. Whether the pills are lost and forgotten about or sold or traded to a friend, once the prescription is filled, they are out of the control of the doctor and the Federal Drug Administration (FDA).

Prescription Drugs and Heroin in Tennessee

The connection between prescription drug abuse and heroin in Tennessee is easy to make when you know the science behind these substances. Opium came first, a highly addictive drug derived from the poppy plant. Poppies grow in Asia, and smoking opium was originally associated with the Chinese, although it spread around the world with trade routes in the 1700s. Opium dens spread throughout the US in the 1800s, long before addiction was understood.

Morphine was extracted from opium resin and used as a pain reliever, especially during the American Civil War. More powerful than opium, morphine was eventually understood to be much more addictive, as well. Codeine is made from another opium extract used for pain relief, although it is not as strong as morphine.

Heroin is made from morphine and was outlawed in 1924. Morphine, codeine, and heroin are opiates, which means they are made from opium. Opioids are synthetic drugs made to mimic the substances found in opium. Opiates and opioids are all highly addictive.

Prescription drug addiction can happen quickly when dealing with opiates or opioids. Sometimes just one dose initiates the addictive behavior in the brain. Addiction is a powerful force that takes over a person’s behavior by altering the pleasure centers in the brain. Once the addiction begins, the desire for that high becomes irresistible.

Prescription drugs can be expensive, especially if you have to take them every day or in larger quantities over time. Health insurance coverage is usually limited to a certain amount of narcotics each month. Once your addiction requires you to have more, another source is needed.

Heroin can produce the same high for recreational users of prescription pain killers. The profitable illicit drug trade has recently attracted more producers and traffickers around the world. An ample supply of heroin makes it accessible and affordable in many areas.

Meanwhile, the pharmaceutical companies have cut the supply of popular opioids, forcing the prices up. In Nashville, for instance, OxyContin costs about $30-35 a pill while a hit of heroin can be as inexpensive as $10. Tennessee cities like Nashville are seeing the rise in prescription drug addiction translating into an increase in heroin use.

Tennessee Prescription Drug Abuse Statistics

Prescription opioid painkillers are one of the biggest problems in prescription drug abuse. They can be extremely addictive and are easily accessible. The Tennessee State Department of Mental Health and Substance Abuse Services estimates that 69,100 Tennesseans are addicted to prescription opioids. In 2012 and for the first time, prescription opioids became the most abused substance in Tennessee, even beating out alcohol.

Alcohol has been the most abused substance in the country for almost a century. It has always been the most socially acceptable drug, and, except in some small areas, it is also the most accessible. The fact that prescription drug abuse has exceeded alcohol abuse in Tennessee is extremely serious because it represents a change in social norms — a change that favors prescription drugs.

Further evidence of the drug addiction epidemic in Tennessee comes in the form of this statistic: between 2005 and 2010 visits to emergency rooms for prescription drug poisoning increased 40%. In roughly that same time period, drug related crimes increased 33%.

Here are some other shocking statistics about drug abuse in Tennessee:

• The drug overdose mortality rate in Tennessee is the eighth highest in the nation.
• Drug overdose rates in Tennessee doubled since 1999.
• Tennessee ranked highest in non-medical use of pain relievers in 2007-2008.
• In Tennessee, rates of illicit drug abuse exceed the national average.
• From 2000 to 2010, drug abuse deaths in Tennessee increased by 250%.
• In Tennessee there were one million addictive medications prescribed each day in 2010.
• In 2012, there were 43,017 drug and narcotic violation arrests in Tennessee.

Opioids are strong medicines meant specifically to treat extreme pain resulting from surgery, serious injury, or chronic disease. The level of pain relief they provide brings previously unavailable relief to those suffering from such pain. The biggest downside is that these drugs are also extremely addictive. Even with proper use, addiction is a risk and needs to be considered with preventive measures and early intervention treatment.

In fact, most addiction to prescription drugs starts out as legitimate use. Because these substances are so addictive, though, a few too many days on the drugs or a couple doubled doses because the pain is so bad can easily result in addiction.

Access to prescription drugs in Tennessee, especially opioid pain relievers, is extremely easy due to doctors writing prescriptions. Doctors in Tennessee wrote narcotics prescriptions at a higher rate than in 48 other states in the country. In 2010, 11.8 kilograms of morphine equivalents were sold per 10,000 people in Tennessee. Other concerning statistics from 2010 for prescription drugs in Tennessee include:

• There was enough Xanax prescribed for everyone in the state over the age of twelve to have 22 pills.
• Oxycodone prescriptions could have supplied 21 pills to each adult in Tennessee.
• Hydrocodone prescriptions written in Tennessee equaled 51 pills for each person over the age of 12 in the state.
• Between 2010 and 2012, there was a 25% increase in prescriptions.

In order to reverse the drug abuse epidemic, Tennessee has to find a way to limit the amount of drugs doctors are prescribing. Educating people about the dangers of seeking unnecessary prescription drugs and putting better controls on controlled substances should help.

Tennessee Prescription Drug Abuse Prevention

Officials discovered the drug abuse epidemic and every news outlet reported it, but the solution will take time and diligent effort. The state of Tennessee has undertaken several initiatives to prevent prescription drug abuse. Their latest ad campaign, “Take Only as Directed,” includes a website and television ads to educate people about prescription drug abuse.

The website defines prescription drug abuse as taking prescription medication in any way other than as directed by a doctor. It points out that taking more of a prescription drug than instructed or taking it for longer than it was intended is considered drug abuse. Taking a prescription intended for someone else or altering its form, like crushing pills into powder for snorting, are also identified as drug abuse behaviors.

In an attempt to prevent prescription drug abuse, “Take Only as Directed” explains that not everyone who abuses prescription drugs does so on purpose. Some people don’t realize the consequences of self-medicating with these narcotics. Even if your intended purpose seems innocent and safe, like weight loss, it is never safe to take prescription drugs without a doctor’s supervision. Prescription drug abuse leads to addiction.

The “Take Only as Directed” website lists commonly abused prescription drugs including:

• Demerol
• OxyContin
• Darvon
• Vicodin
• Dilaudid
• Xanax
• Dexedrine
• Valium
• Ritalin

Preventing prescription drug abuse begins with education. Knowing what it means to abuse prescription drugs can help you avoid a potentially dangerous situation. Recognizing the signs of drug abuse in yourself or others is important as well. Signs of drug abuse can include:

• Continuing to take drugs after you experience negative side effects
• Using drugs to avoid withdrawal symptoms like anxiety or depression
• Developing a tolerance for drugs so that you need a larger dose to get the same effect
• Focusing a majority of your time and energy on thinking about, obtaining, and taking drugs
• Changing your regular activities to accommodate taking drugs
• Losing friends or jobs as a result of your drug use

Tennessee Drug Prevention Policy and Practice

The Center for Disease Control (CDC) and other national organizations evaluate state drug addiction prevention policies and practices for their effectiveness in reducing drug overdose deaths. As of 2013, Tennessee has enacted pain clinic laws rated green by the CDC. A green rating is given to policies and practices that meet certain criteria for state oversight, clinic ownership, and other elements that are proven effective.

Tennessee also received a green rating for their prescription drug monitoring programs, indicating they meet basic standards for best practices. Policies currently in place in Tennessee involve providing doctors and pharmacies access to monitoring programs, laying out requirements for reporting issues to law enforcement, and coordinating with at least one other state.

These positive ratings indicate hope for reversing the drug epidemic. Tennessee is taking action to try to improve the situation, but change comes slowly and requires a coordinated effort on several fronts across the state.

Prevention Alliance of Tennessee

The Prevention Alliance of Tennessee (PAT) is a statewide alliance of coalitions dedicated to preventing substance abuse. PAT works to inform the public and lawmakers about substance abuse prevention and other public health issues. It advocates for environmental change that would reduce the rate of prescription drug abuse in the state, even lobbying lawmakers for more effective policies and regulations.

There are 52 active coalitions across Tennessee working together for healthy, drug-free communities. These coalitions are deeply rooted in the communities where they can have a greater impact on more people. The coalitions delivered 53 million messages and strategies to Tennessee residents in 2013 alone, advocating for drug abuse prevention.

Prescription Drug Abuse Prevention in Tennessee

State-wide efforts to end the prescription drug abuse epidemic in Tennessee can be broken down into five categories: prevention, early intervention, enforcement, treatment, and recovery. There are a number of efforts, some new and others existing for several years, operating throughout the state. More recent efforts to curtail the drug abuse activity and mortality rate attempt to tie these separate initiatives together for more effective results.

In 2014, Gov. Haslam announced a 7-point plan to fight prescription drug abuse in Tennessee. The program, Prescription for Success, has seven specific goals:

1. Reduce the number of Tennessee residents who abuse controlled substances
2. Decrease the number of overdoses in Tennessee
3. Reduce the amount of controlled substances dispensed in the state
4. Create more drug disposal outlets accessible throughout the state
5. Improve treatment and recovery services for drug abuse
6. Improve interagency coordination throughout the state
7. Increase collaboration with other states

This comprehensive program is a response to the drug abuse epidemic. In addition, Tennessee has increased law enforcement efforts to stop trafficking that brings drugs in from other states.

Learn More About Prescription Drug Abuse

Prescription drug addiction affects people across all age groups and demographics. It is a different scenario for many people who never thought they were abusing drugs or in danger of developing an addiction. People come in contact with prescription drugs for many different reasons. The most addictive prescription drugs are generally prescribed for pain. It is entirely possible that you were only taking the drugs your doctor prescribed for pain following routine surgery when you became addicted to narcotics.

When it comes to any type of drug addiction, prevention can provide the best outcome. It is important to follow your doctor’s instructions when it comes to prescription medication and to be aware of the potential addiction risk. Never take medication prescribed to someone else, and never share your medications with anyone. Watch for signs of addiction and alert your doctor right away. Prescription painkillers need to be handled with caution.

Prescriptions are a safeguard against drug abuse and overdose. When you are treated by a doctor, always tell him what medications you are currently taking, especially if they were prescribed by another doctor. Getting your prescriptions filled at the same pharmacy whenever possible will also help you take advantage of safeguards built into the system.

Never take medication for any reason other than why it was prescribed to you. If you want help losing weight, talk to your doctor about a diet aid. Do not overdose on narcotics because someone told you they are good for weight loss. Overdose and addiction are serious problems, and they can be deadly.

Learn the warning signs of addiction, especially if you are taking opioid pain relievers or other highly addictive medications. Knowing what to look for can help you detect addiction in the early stages and get intervention right away. Addiction is a serious condition that only worsens over time.

If you are struggling with prescription drug abuse or addiction of any sort, the best thing to do is seek help right away. Addiction can be treated, and the sooner you start treatment, the sooner you can return your life to normal. Reach out to 12 Keys to learn more about overcoming addiction.

Contact 12 Keys today to begin learning about addiction and the most effective treatments available. We apply a combination of experience and varied treatment modalities to individualize a recovery program that is right for you. Whether you have been addicted to an opioid painkiller for five months or you have been using heroin for five years, 12 Keys can help guide you on a new journey toward a happy, healthy, substance-free life.